ABSTRACT
Background: Pregnancy induced hypertensive disorders are one of the commonest complication of pregnancy which accounts for 12% of the maternal and perinatal mortality and morbidity. Dyslipidemias are associated with endothelial dysfunction that may result in proteinuria and hypertension which is a clinical hallmark of PIH. It affects both maternal health as well as fetal growth. Hence, this study was done to assess the role of altered lipid profile in the development of PIH.Methods: A Case Control study was conducted at the Department of Biochemistry, Kurnool Medical College and Govt General Hospital, Kurnool in collaboration with its Obstetrics Dept during the period of November 2015-2017. A total of 300 pregnant women, primigravida /multigravida with singleton pregnancy, in the age group of 18‐ 35 years with >20 weeks of gestation were included in the study. Subjects were divided into gestational hypertensives, n=39 (BP ≥140/80) and preeclamptic women, n=111 (≥140/80 and proteinuria) as cases. Age matched normotensive pregnant women, n=150 (BP 120/80) were recruited as Controls. Subjects with history of multiple pregnancies, pregnancy with congenital anomalies, chronic hypertension, diabetes mellitus, cardiac/thyroid/hepatic/renal disease, dyslipidemia were excluded. Total cholesterol, TG, HDL, LDL, VLDL were performed.Results: A comparison of these values between hypertensive and normotensive women showed a significant rise in TC, TG, LDL and VLDL. HDL-C showed a significant decrease in hypertensive women compared to normal pregnant women. LDL: HDL and TG:HDL ratios were higher in PIH group.Conclusions: The results of this study suggests an abnormal lipid metabolism, predominantly high TG concentrations and low HDL-C, which may add to the promotion of vascular dysfunction and oxidative stress seen in PIH. This association is significant in understanding the development of hypertension during pregnancy and is useful in early diagnosis and prevention of PIH.
ABSTRACT
Background: A maternal near-miss case is defined by World Health Organization (WHO) as “a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy.” Severe acute maternal morbidity (SAMM) is the acronym for the more popular term of ‘near-miss’ cases. There are approximately 118 life threatening events of “near miss mortality” or SAMM for each maternal death. Analysing near miss cases can prevent maternal death.Methods: It is a retrospective study based on medical records. Sample size is all the pregnant cases admitted in Department of Obstetrics and Gynecology in AIMSR, Hyderabad, Telangana, India over the period of January 2015- June 2017 (two and half years) i.e. 2276. All records were gathered and each record that satisfy near miss criteria/maternal mortality were segregated, data has been collected on the occurrence of severe pregnancy-related complications or those who require critical interventions and admission to intensive care unit as per the proforma (according to WHO near miss questionnaire). Data entry done in MS Excel and analyzed using Epi Info.Results: Total MNM/SAMM patients were 85 out of 2276 pregnant women (3.7%). The duration of the stay, potential life-threatening conditions (PTLC), critical interventions, organ dysfunctions, mode of delivery, treatment for PPH, hypertensive disorders and associated conditions among SAMM patients were calculated. SAMM patients who has severe post-partum hemorrhage PPH were 24.7%, severe pre-eclampsia was 31.7%, eclampsia was 2.4%, patients with both severe PPH and eclampsia were 2.4%.Conclusions: Near misses can be prevented to some extent by spreading awareness about possible obstetric complications and risk stratification. The WHO tool for analysis of maternal near miss or SAMM can identify more preventable causes of maternal death. Prospective monitoring of maternal morbidity may be useful in identifying determinants of severe maternal mortality.
ABSTRACT
Background: Acute Lymphoblastic leukaemia is a malignant condition resulting due to continuous clonally proliferation of progenitors of lymphoid cells. The objective is to identify the association between dermatoglyphics and acute lymphoblastic leukaemia and to assess the value of dermatoglyphics as a screening tool.Methods: A case-control study was conducted on a total of around 60 subjects below the age of 15, out of which 30 children were already diagnosed and suffering from Acute Lymphoblastic Leukaemia and the other 30 were age and sex matched controls. Fingerprints of 30 affected children were taken through an ink-pad method in both hands, analyzed and compared with controls. Information regarding any significant familial history was obtained.Results: The study suggested with an increased rate of incidence among children of age group 3-4 years and with a male preponderance (63.3%).The findings were found to be statistically significant with an association between whorls and loops among cases and controls with higher frequency of whorls in cases and loops in controls (p value < 0.05), whereas association between whorls, arches and loops, arches was not significant. In quantitative analysis, most of the cases (n=12, 39.6%) had a PII in the range of 16-20 whereas most of the controls (n=22, 72.6%) had it in the range of 11-15, with significant overlapping.Conclusions: The findings are suggestive of association of fingerprint pattern with the patients suffering from Acute Lymphoblastic Leukaemia and therefore they might help in early diagnosis of the condition in high risk children and thus can be helpful as a screening tool.